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British Columbia's vaccine mandate for health care workers applies to unionized staff and physicians, students and volunteers who serve in public-health facilities.

JONATHAN HAYWARD/The Canadian Press

More than 100,000 health care workers in British Columbia will have to be fully vaccinated against COVID-19 as a condition of employment by Oct. 26.

The policy applies to unionized staff and physicians, students and volunteers who serve in public-health facilities that are accessible to patients, and comes as pressure grows on acute care services owing to unvaccinated COVID-19 patients.

“We are now in a place where we need to take additional measures,” said Bonnie Henry, B.C.’s Provincial Health Officer.

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The province has already given workers in long-term care facilities notice of the vaccination requirement. Dr. Henry said the broader policy will ensure that vaccine-hesitant health workers in nursing homes won’t be able to transfer into other parts of the health care system.

“There are settings where we cannot afford to have unvaccinated health care workers,” she said.

The vaccine policy is a significant change by public-health officials, after months of seeking voluntary compliance from health care workers. It comes as the risk associated with being unvaccinated is becoming clearer: On Monday, 139 people were in critical care with COVID-19 in B.C. hospitals, and 121 of them were unvaccinated.

The province does not have data to show vaccination rates among health care workers, but their unions report that levels are higher than in the general population. Dr. Henry said the system has only small pockets of unvaccinated workers. A very few will have a legitimate medical reason that will have to be accommodated, she said, but most unvaccinated workers can expect to be reassigned or put on leave without pay under the new policy.

Across the country, vaccination policies are becoming a reality in a variety of workplaces. The federal government has announced it will require federal public servants to be vaccinated, and employers in federally regulated industries and Crown corporations are expected to do the same. Private corporations are setting their own requirements, and airlines, along with the country’s five largest banks, are making vaccination a condition of employment.

B.C. was the first province to impose such a mandate in long-term care, where residents are at high risk of coronavirus infection.

Staff and residents of long-term care facilities were given priority access to COVID-19 vaccines, and the number of pandemic-related deaths in those homes has declined, but outbreaks persist. In the most recent report from the B.C. Centre for Disease Control, which tracks data up to Aug. 28, more than half of recent deaths due to COVID-19 in the province are linked to care facilities.

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All the employees in long-term care and community care facilities are required to be fully immunized by Oct. 12.

Mike Old, a spokesperson for the Hospital Employees’ Union (HEU), said the best approach to increase vaccination rates among health care workers is providing increased access to clinics and credible information on the vaccines. However, he said the union is encouraging its members to be vaccinated, and to follow the orders of the Provincial Health Officer.

“We want as many health care workers as possible to be vaccinated,” he said. He added that at least 90 per cent of HEU’s 50,000 members have done so.

Health care unions in B.C. historically have opposed mandatory vaccinations and have spent years in arbitration over the influenza shot. But Mr. Old said the COVID-19 vaccines are different. “Unlike the flu vaccine, COVID-19 vaccines have been shown to be extremely effective, and they have been a game-changer in long-term care and community living.”

In addition, current collective agreements with B.C.’s health unions generally give health employers the right to require vaccinations.

The labour contract covering the HEU says: “Any employee refusing, without sufficient medical grounds, to take medical or x-ray examination at the request of the employer, or to undergo vaccination, inoculation and other immunization when required, may be dismissed from the service of the employer.” The BC Nurses’ Union and the Health Sciences Association of British Columbia have similar language, with exceptions made for those who have a medical exemption.

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Several groups have called for a vaccination mandate. The Canadian Medical Association and the Canadian Nurses Association would like to see a requirement that all health care workers be inoculated.

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